PsychMD.info - Depression

Depression

What is Depression?

Depression is a serious medical illness. It is not something that you have made up in your head. It's more than just feeling "down in the dumps" or "blue" for a few days. It's feeling "down" and "low" and "hopeless" for weeks at a time. A depressive disorder is an illness that involves the body, mood, and thoughts. It affects the way a person eats and sleeps, the way one feels about oneself, and the way one thinks about things. A depressive disorder is not the same as a passing blue mood. It is not a sign of personal weakness or a condition that can be willed or wished away. People with a depressive illness cannot merely "pull themselves together" and get better. Without treatment, symptoms can last for weeks, months, or years. Appropriate treatment, however, can help most people who suffer from depression.

Signs and Symptoms:

persistent sad, anxious, or "empty" mood
feelings of hopelessness, pessimism
feelings of guilt, worthlessness, helplessness
loss of interest or pleasure in hobbies and activities that were once enjoyed, including sex
decreased energy, fatigue, being "slowed down"
difficulty concentrating, remembering, making decisions
insomnia, early-morning awakening, or oversleeping
appetite and/or weight loss or overeating and weight gain
thoughts of death or suicide; suicide attempts
restlessness, irritability
persistent physical symptoms that do not respond to treatment, such as headaches, digestive disorders, and chronic pain

How common is Depression?

About 9.5% of U.S. adults ages 18 to 54 (= 18.8 million people) have Depression during the course of a given year.

Treatment (combination of psychotherapy and medication(s) may be helpful):

cognitive-behavioral therapy (CBT): learning how to identify, evaluate and modify distorted cognition by changing thoughts and behaviors can help the patient manage depression more effectively.
interpersonal therapy: focus on the patient's disturbed personal relationships that both cause and exacerbate (or increase) the depression.
psychodynamic therapy: focuses on resolving the patient's conflicted feelings.
medications: some of the medications that have been used to treat Depression include:
- fluoxetine (Prozac)
- sertraline (Zoloft)
- fluvoxamine (Luvox)
- paroxetine (Paxil)
- citalopram (Celexa)
- escitalopram (Lexapro)
- duloxetine (Cymbalta)
- venlafaxine (Effexor)
- buproprion (Wellbutrin)
- mirtazapine (Remeron)
- nefazodone (Serzone)
- trazodone (Desyrel)
- amitriptyline (Elavil)
- clomipramine (Anafranil)
- doxepin (Sinequan)
- protriptyline (Vivactil)
- nortriptyline (Pamelor)
- imipramine (Tofranil)
- desipramine (Norpramin)
- phenelzine (Nardil)
- isocarboxazid (Marplan)
- tranylcypromine (Parnate)
Electroconvulsive therapy (ECT): useful for individuals whose depression is severe or life threatening or who cannot take antidepressant medications; also for patients who don't respond sufficiently to antidepressant medications. In recent years, ECT has been much improved. For full therapeutic benefit, at least several sessions of ECT, typically given at the rate of three per week, are required.

Before taking medication for Depression:

Ask your doctor to tell you about the effects and side effects of the medication he or she is prescribing.
Tell your doctor about any alternative therapies or over-the-counter medications you are using.
Ask your doctor when and how the medication will be stopped. Some medications cannot safely be discontinued abruptly; they have to be tapered slowly under a physician's supervision.
Be aware that some medications are effective only as long as they are taken regularly, and symptoms may occur again when the medications are discontinued.
Work together with your doctor to determine the right dosage of the right medication to treat Depression.

Reference: National Institute of Mental Health